by Dr. Lisa Brekke, PT, DPT

A recent article in U.S. News highlights a new research study that emphasizes early access to physical therapy as a key to concussion recovery.  

The study followed over 200 adults recovering from mild traumatic brain injuries or concussions who were within two to 12 weeks (about 3 months) from their date of injury. The research concluded that starting physical therapy within two months is the best window to optimize recovery and ensure that the brain does not compensate for the initial injury, which can be detrimental in the long run.  

Why do you want to avoid compensation post-concussion?

To understand the concerns related to post-concussion compensation, it is important to understand that a concussion is a mild traumatic brain injury that affects brain function and can occur when there is an impact to the head or body. Concussions are diagnosed by the individual’s complaints and an objective examination. CT scans may be obtained initially to ensure there are no skull fractures or brain bleeding.  

Concussion is a functional change to an individual’s brain, not a structural change. Functional changes in how the brain works happen because of changes to the chemical and energy-related processes that help protect it from more damage. When a concussion is left untreated, it’s like the main road stays under construction and our brains learn to take a detour instead of using the main path. This is initially helpful as the brain heals and begins to reopen its main pathway. However, without the proper physical therapy for recovery, this main road doesn’t get utilized and new connections are made along the detour.  

These detours are extremely helpful immediately to allow us to function; however, post-concussion they lead to detrimental effects as they are bypassing the most efficient route, burn more energy to complete tasks, and teach our brains to rely on certain systems more than others.

We have compensations that may include moving the whole body instead of turning your head, turning your head instead of shifting your eyes, avoiding head movements, avoiding phone and computer use, avoiding grocery stores, not driving, and not working out. These adjustments cause less information to reach our brain from our eyes, balance system, and posture, which can lead to problems like headaches, dizziness, trouble staying balanced, eye discomfort, brain fog, and difficulty thinking clearly as we keep trying to cope with these changes.

What does physical therapy do for concussion sufferers?

Physical therapy after a concussion focuses on finding out what your brain is struggling to adjust to and helping you gradually return to your normal activities. This will involve you describing your symptoms, as well as what increases and decreases them. It will also include an assessment of your neck, eyes, inner ears, and cardiovascular fitness, as these areas can be affected after a concussion. We will work with your physicians to provide reasonable accommodation for school or work while you are recovering and provide you with exercises and guidelines for activities in your daily life to allow for full recovery. You may also be referred to other medical providers with specialties that aid in your recovery.  

So, what should you do?

If you suspect that you have a concussion or have been diagnosed with a concussion, see a physical therapist as soon as possible. There are physical therapists who specialize in concussion recovery, and they will be able to help you with the initial phases of recovery as well as progress you back to your prior level of function. This may require a collaborative approach, and your specialized physical therapist will have the resources and help you along the way.  

Does this mean you are stuck with symptoms if you didn’t do physical therapy initially?

This does not mean you can’t see a physical therapist if your injury was more than two months ago. Physical therapy can help at any point of your recovery, even years down the road.  

Please don’t hesitate to reach out to us online or call 866-588-0230 with any questions or to schedule.

References:  
Article referenced by U.S. News: Physical Therapy & Rehabilitation Journal, study, Dec. 18, 2024; OHSU, news release, Dec. 19, 2024; The Washington Post, media report, Jan. 5, 2025 
Picture reference: https://thebraindocs.com/wp-content/uploads/2023/06/Cognitive-Reserve-Neuroplasticity-The-Brain-Docs-Sherzai-MD-1024x693.webp 

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